Background: Oesophageal varix is one of the major complications of liver cirrhosis. Repeated endoscopic examinations are unpleasant for patients and also have cost impact. The aim of the study was to determine the predictive value of liver right lobe diameter to serum albumin ratio, a non-invasive parameter for the prediction of esophageal varices. Methods: A Cross-sectional observational study was carried out on cirrhotic patients in Gastroenterology department, Dhaka Medical College Hospital, Dhaka. Patients were subjected to complete blood picture, liver functions, viral markers; abdominal ultrasonography, upper gastrointestinal endoscopy and calculation of the Liver right lobe diameter to serum albumin ratio were done. Statistical analysis was done using SPSS software version 23. Results: A total number of 80 patients were included. Age of the patient (mean ± SD) was 47.00±14.53 years, while 57(71%) were men. Regarding etiology, 40(50%) patients had HBV and 10(12.5%) in HCV. Child-Turcotte-Pugh grades showed 54(67.5%) had CTP grade B, followed by 23(28.7%) grade A. Esophageal varices were observed in 65(81%) of the patients. The mean liver right lobe diameter to albumin ratio was 4.5±0.57 in patients having oesophageal varices and 3.9±0.27 in patients without oesophageal varices which was statistically significant (p values 0.01). The best cut off value of liver right lobe diameter to serum albumin was determined at the highest point of Youden index, which was 4.16. With this cut off value, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy was 73.8 %, 60.6 %, 88.8 %, 34.6% and 71.2% respectively. Conclusion: This ratio is a useful noninvasive predictor for the presence of oesophageal varices but cannot be advocated clinically due to low sensitivity and specificity. It may serve for selection of patient who need urgent endoscopy and helps when endoscopy facilities are limited or contraindicated or restricted like Covid-19 pandemic situation. Bangladesh J Medicine 2022; 33: 18-23

Background: Urinary tract infection is one the most common infection in clinical practice. Uropathogens have the ability to form biofilm in urinary tract, frequently within the indwelling catheter. Microorganism growing in a biofilm is associated with chronic and recurrent UTI and less sensitive to antimicrobial agent. So, the aim of the present study was to detect biofilm-producing uropathogenic bacteria by microtiter plate assay and antibiotic sensitivity pattern of biofilm- producing and biofilm non-producing organisms. Methods: This cross- sectional observational study was carried out in Microbiology Department, Chattogram Medical College, Bangladesh. Urine samples were collected from outpatient’s department and inpatients of different wards. Standard microbiological procedures and biochemical tests were carried out. Antibiotic susceptibility test was performed by using the Kirby-Bauer disk diffusion technique. Biofilm production was detected by Microtiter plate method (MPM). Results: Out of 252 tested samples, 73(55.3%) organisms were isolated from non-catheterized urine and 74(61.66%) from catheterized urine samples. The most frequently isolated organism was Escherichia coli (60.27%, 50%) in both non- catheterized and catheterized patients followed by Klebsiella spp. (21.91%, 27.02%); Pseudomonas spp. (9.58%, 12.21%); Acinetobacter spp. (1.36%, 4.05%); Staphylococcus aureus (4.1%, 2.7%) respectively and 2.7% CoNS from non-catheterized patients. In the non- catheterized patients, 19 (26.02%) out of 73 bacterial isolates were biofilm-forming and in the catheterized patients, 33 (44.59%) out of 74 bacterial isolates were biofilm forming. The maximum biofilm-producing organism was Escherichia coli in both isolates. Biofilm- producing organism found relatively high resistance against tested antibiotics. Imipenem, Amikacin, Nitrofurantoin, and Piperacillin-tazobactam are the few microbial agents that are effective against biofilm-producing gram-negative organisms ..

Background: This longitudinal descriptive study was conducted for the first time in the department of Pathology, Rajshahi Medical College in order to evaluate the prognostic significance of serum TgAb as a tumor marker for differentiated thyroid carcinoma. Objective: The aim of this study to detect the antibody positive differentiated thyroid carcinoma using serum TgAb and compare with the FNAC and histopathological findings. Method: A total forty patients of clinically, radiologically and by FNAC diagnosed as differentiated thyroid carcinoma were selected attending in the department of Otolaryngology, Rajshahi Medical College Hospital from January 2010 to December 2011. Preoperative serum TgAb level (TgAbl) was measured in all patients taking cut off value as 40 IU/ml. Biopsy material were examined for histopathological diagnosis. 3-6 months after thyroidectomy postoperative serum TgAb level (TgAb2) was measured in those patients only who were TgAbl positive. Result: The correlation, association and statistical analysis of preoperative and postoperative serum TgAb level were computed against histopathological diagnosis. Out of forty cases, 35 were papillary and 5 were follicular carcinoma. Mean age was 25.48+9.70 years and Male: Female was 1:6. In this study, 9 cases (22.5%) were TgAb positive preoperatively and 2 cases showed highest level 3000 and 2200 IU/ml. Post operative TgAb level of 9 cases showed significant reduction. Statistical analysis demonstrates significant correlation (P=<0.01) and association (P=<0.05) between preoperative and postoperative TgAb level. Conclusion: So, it is concluded that serum TgAb level can be used as a tumor marker in antibody positive differentiated thyroid carcinoma.

Background: Escherichia coli and Klebsiella spp. are the most common organisms causing urinary tract infection (UTI) and commonly responsible for extended spectrum beta lactamase (ESBL) production. This study was carried out to detect ESBL producing uropathogenic Escherichia coli and Klebsiella spp. by phenotypic and genotypic method. Rapid and accurate detection of ESBL producing E. coli and Klebsiella spp. has an important role to avoid treatment failure. Materials and Methods: This was a cross sectional observational study and carried out in department of microbiology in Chittagong Medical College, Bangladesh from January to December 2017. Urine was collected from suspected UTI patients and standard microbiological and biochemical tests were carried out. ESBL producing E. coli and Klebsiella spp. were identified by phenotypic confirmatory disc diffusion test (PCDDT). Polymerase chain reaction (PCR) was performed by using standard protocol with specific primers. Results: 448 urine samples were collected. Among them, 140 showed bacterial growth; 72 were E. coli and 35 were Klebsiella spp. Among E. coli 38(52.8%) and in Klebsiella spp. 15(42.9%) were detected as ESBL producers by PCDDT respectively. Among E. coli, 41(56.9%) and in Klebsiella spp. 21(60%) strains produced ESBL genes by PCR. Out of 38 phenotypically positive E. coli, 7 strains do not carry any detectable genes. Similarly, out of 15 phenotypically positive Klebliella spp. 3 isolates did not produce any detectable gene. On the other hand, 10 E. coli isolates and 9 Klebsiella spp. carry detectable genes although these were not phenotypically ESBL producers. Moreover, ESBL producing E. coli and Klebsiella spp. showed more multidrug resistant than Non-ESBL producing E. coli and Klebsiella spp. Conclusion: This study revealed that large portion of E. coli and Klebsiella spp. was ESBL producers. PCR can detect some additional cases of ESBL producing isolates. So, PCR can be used along with phenotypic ......